CC Resolution 8821
~~C1Lt:: Ul 1...C1I1IUClIICl
- OFFICE OF
EMERGENCY SERVICES
L.l1.::.a;)u.1 1~1.I1I11JC:1
..LU"U
.\
DESIGNA nON OF
APPUCANT"S AGEN:r RESOLunON
RESOLUTION NO. 8821
BE IT RESOLVED BY THE Ci tv Council
llIcNnI of Direclon Of Gowenw'IIIocIyI
, OF THE
City of Camph~ll
l~oI~
THAT
Bill Helms
1"- of Deugna1_ ~I
Environmental Program Manager
C11lIeI
OR
Steve Conway
Accounting Manaqer
1"- of 0n0clM1_ Alena
lTitIel
OR
1"- 01 DeugnelM Agenl'
lTille'
is hereby authorized to execute for and in behalf of the Ci tv of Campbell . a public entity
.~ or u'..,.zaaonJ
established under the laws of the State of California, this application and to file it in the Office of Emergency Servi{
for the purpose of obtaining certain federal financial assistance under P.L. 93-288 as amended by the Robert T. Stat
Disaster Relief and: Emergency Assistance Act of 1988, and/or state financial assistance under the Natural Dis~
Assistance Act for' Flood . which occurred in March of 1995
lFire. FIoocl. UnflQualle. ece.l \MOft1II/DMe' IY_.
THAT the Ci ty of Campbell . a public entity established under the laws of the State of
'Nem. or uroanazauonl
California, hereby authorizes its agent to provide to the State Office of emergency services for all matters pertainin
such state disaster assistance the assurances and agreements required.
Dassed and approved this
16 day of Mav ~-'nl
IU.K.) ~_...
Donald R. Burr, Ma~
. 19 95
",.."
c-~~~
C"- end Title 01 AflIIrClWlllIloerll Of Counc:il ............
l~ end T.... Of AJprClWlllIloerll Of Counc:il ............
CN8me end Title 01 AoProw>9 ..... Of -:0UllCll ...........,
CERTIRCA TION
I,
Anne Bybee
1"-1
. duly appointed and Ci tv Clerk
lTltte of CIwIl Of Cenityine 0ItlIMCI
of
City of Campbell
I~ of Ore-alJOftl
. do hereby certify that the above is a true and correct cop
a resolution passed and approved by the
City Council
.... of Dorec_ Of o.w.nwoe -.cIyI
of the
City of Campbell
1"- 01 Otv-non'
on the 16
co....
day of
May
CMDmfII
19~
lY ....
"ate:
~~- II K /q~
I
Av'\ V\€ ~b ee-
ICIerIl Of ClIft"yIng OfIa.1l
/~\
/// .)0__
/(/YJ~ .~ ~
1~1
OfS Form 130 IAlIY 81M! DA8 Form
FEDERAL EMERGENCY MANAGEMENT AGENCY
NOTICE OF INTEREST
IN APPLYING FOR FEDERAL DISASTER ASSISTANCE
PAPERWORK BURDEN DISCLOSURE NOTICE
Public reporting burden for this form is estimated to average3~ minutes ~er ~e~ponse. This includes the tim~ fo
reviewing instructions, searching existing data sources, gathering and malntalOlng the data needed, completing,
reviewing, and submiting the form. Send comments regarding this burden estimate or any aspect of this requirement
including suggestions for reducing this burden to: Information Collections Management, Federal Emergenc'
Management Agency, 500 C Street, S.W., Washington, D.C. 20472; and to the Office of Management and Budget
Paperwork Reduction Project (3067-00331. Washington, D.C. 20503.
"NOTE: Complete fonn and turn into the Governor's Authorized Representative at the Applicants Briefing for this majo
diaster, but not later than 30 days after your County is designated eligible for Public Assistance".
DECLARATION NUMBER PROJECT APPLICATION NUMBER NOI DATE
(For Agency Use Only-FPS #)
a.M.B. NO. 3067-0033
Expir.s May 31, '996
FEMA. 1 0 4 6
-OR
March 28, 1995
The purpose of this fonn is to list damages to property and facilities so that inspections may be appropriately assigned for
, fonnal survey.
REQUIREMENTS FOR FEDERAL DAMAGE SURVEYS
A. DEBRIS CLEARANCE
D On public Roads & Streets including ROW
JaI Other Public Property
o Private Property (When undertaken buy local govt. forces)
~ Structure Demolition
B. PROTECTIVE MEASURES
D Ufe and Safety
D Property
o Health
D Stream/Drainage Channels
;. ROAD SYSTEM
o Roads 0 Streert
fiOl: Bridges 0 Culverts
o Control Traffic
D*
D. WATER CONTROL FACILITIES
D Dikes 0 Dams
D Drainage Channels 0 Irrigation Works
o Levees 0 .
F. PUBLIC UTILITY SYSTEMS
o Water DSanitary Sewerage
D Stann Drainage 0 Light/Power
0*
E. BUILDINGS AND EQUIPMENT
o Buildings and EqUipment
D Supplies or Inventory
D Vehicles or other equipment
D Transportation Systems
0*
G. OTHER (Not in the above categories)
o Park Facilities
D Recreational Facilities
* Indicate type of facilitiy
NAME OF POLITICAL SUBDIVISION OR ELIGIBLE APPLICANT (NOTE: If
private Non-profit. provide name of facility and/or Non-Profit Owner)
City of Campbell
REPRESENTATIVE 1.
PRIVATE NON-PROFIT
DYES g) NO
COUNTY
Santa Clara
Bill Helms,' Public Works Department
BUSINESS ADDRESS (Include Zi~,;ode)
70 North First Street
Campbell, CA 9?008
BUSINESS TELEPHONE (Include ArfJa CodfJ ana EAI nsion)
(408) 866-2150
REPRESENTATIVE 2.
Steve Conway, Finance Department
BUSINESS ADDRESS (Include Zip Code)
Same
TELEPHONE (Include Area Code and Extension)
~408) 866-2113
fEMA form 90-49, MAY 94
~Elf' A(,f~ ALL PRE:. \,',0\1<; 1.>11101\1"
,..'\